<?php
function block_column(  $word ,$skip =array() ,$length = 26 ){
$view = '<table cellspacing="0" style="width:100%;"><tr>
<td style="width:2%;text-align:center;border:0px;"> :</td>';
$letter = strtoupper($word);
 //$letter = explode("", $string);
$length = ($length>26 OR $length<0) ? 26 :$length;
for($i=0; $i<=$length-1;$i++){
	if(in_array($i+1 , $skip))
		$view .='<td style="font-size:14px;border:0px;height:15;width:12px;">&nbsp;</td>';
	else
		$view .='<td style="font-size:14px;border:1px;height:15;width:9px;text-align:center;">'.$letter[$i].'</td>';
}

$view .='</tr></table>';
 return $view;
}
?>
<style type="text/css">
<!--

	table.page_header {width: 100%; border: none; background-color: #CDCDCD; border-bottom: solid 1mm #000; padding: 2mm }
	table.page_footer {width: 100%; border: none;  border-top: solid 1mm #000; padding: 2mm}
div.zone
{
	border: solid 2mm #66AACC;
	border-radius: 3mm;
	padding: 1mm;
	background-color: #FFEEEE;
	color: #440000;
}
div.zone_over
{
	width: 30mm;
	height: 35mm;
	overflow: hidden;
}
td {
	font-size:11px;
	line-height:18px;
}
-->
</style>
<page  format="242x360" orientation="P" backtop="0" backbottom="0" backleft="0" backright="0"> 
 
<div style="width:100%;margin-left:-4px;padding:0;">
<table style="width: 100%;" align="center">
	<tr>
	<td style="width: 50%;text-align:left"><!-- img src="files/1721_corner.png" -->0</td>
	<td style="width: 50%;text-align:right"><!-- img src="files/1721_corner.png"-->0</td>
	</tr>
</table>	
</div>
<div style="width:97%;margin-left:11px;">
<table style="width: 99%;" align="center">
	<tr> 
		<td style="vertical-align: top; padding: 2px; width: 3%;text-align: left;">
		<!-- img src="files/1721_formulir.png"-->
		</td>
		<td style="font-size:10px;vertical-align: top; padding:0; width: 23%; text-align: center; border-right:1px solid; ">
			<span style="font-size:32px;width:100px;text-align:center;height:35px;">1721-A1</span> <br>
			<br><span>
			DEPARTEMEN KEUANGAN RI<br>
			DIREKTORAT JENDERAL PAJAK</span>
		</td>
		<td style="font-size:12px;height:87px;vertical-align: middle; padding: 2px; width: 47%; text-align: center;"> 
		BUKTI PEMOTONGAN PAJAK PENGHASILAN PASAL 21 BAGI
		PEGAWAI TETAP ATAU PENERIMA PENSIUN ATAU TUNJANGAN 
		HARI TUA/TABUNGAN HARI TUA/JAMINAN HARI TUA
		</td>
		<td style="border-left:1px solid;vertical-align: top; padding: 2px; width: 2%; text-align: left;"> 		
		<!--img src="files/1721_tahun_kalendar.png"-->
		</td> 
		<td style="vertical-align: top; padding: 2px; width: 22%; text-align: left;"> 
		<div style="font-size:9px;">
			1. Lembar 1 untuk Pegawai<br>
			2. Lembar 2 untuk Pemotong Pajak<br>
		</div><br>
		<table style="width:100%" cellspacing="0">
			<td style="font-size:24px;border:1px;text-align:center; height:24px;width:22%"> 2</td>
			<td style="font-size:24px;border:1px;text-align:center; height:24px;width:22%"> 2</td>
			<td style="font-size:24px;border:1px;text-align:center; height:24px;width:22%"> 2</td>
			<td style="font-size:24px;border:1px;text-align:center; height:24px;width:22%"> 2</td>
		 </table><br>
		 
		</td> 
	</tr> 
</table>
<div style="border:1px solid;height:20%;width:99%">
<table style="width:100%;">
	<tr>
		<td style="font-size:12px;width:42%;height:20px;">NOMOR URUT</td>
		<td style="width:58%"><?php echo block_column(  '0001' ,array() ,7 );?></td>
	</tr>
	<tr>
		<td style="font-size:12px;width:42%;height:20px;">NPWP PEMOTONG PAJAK</td>
		<td style="width:58%"><?php echo block_column(  '01 402 213 6 401 000' ,array(3,7,11,13,17) ,20 ); ?></td>
	</tr>
	<tr>
		<td style="font-size:12px;width:42%;height:20px;">NAMA PEMOTONG PAJAK</td>
		<td style="width:58%"><?php echo block_column(  'PT KRAKATAU MEDIKA' ,array(0) ,26 ); ?> </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:42%;height:20px;">ALAMAT PEMOTONG PAJAK</td>
		<td style="width:58%"><?php echo block_column(  'JL SEMANG RAYA CILEGON' ,array(0) ,26 ); ?> </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:42%;height:20px;">NAMA PEGAWAI ATAU PENERIMA PENSIUN /THT /JHT</td>
		<td style="width:58%"><?php echo block_column(  'EDI SUBANDI' ,array(0) ,26 ); ?> </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:42%;height:20px;">NPWP PEGAWAI ATAU PENERIMA PENSIUN /THT /JHT</td>
		<td style="width:58%"><?php echo block_column(  '07 763 357 6 401 000' ,array(3,7,11,13,17) ,20 ); ?> </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:42%;height:20px;">ALAMAT PEGAWAI ATAU PENERIMA PENSIUN /THT /JHT</td>
		<td style="width:58%"><?php echo block_column(  'JL SEMANG CILEGON RAYA' ,array(0) ,26 ); ?> </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:42%;height:20px;">STATUS, JENIS KELAMIN, DAN KARYAWAN ASING</td>
		<td style="width:55%;font-size:9px;vertical-align:middle;">   
		<table style="width:100%;">
			<td style="width:1%">:</td>
			<td style="width:3%"><img src="files/1721_box.png"></td>
			<td style="width:8%;font-size:9px;">KAWIN </td>
			<td style="width:3%"><img src="files/1721_box.png"></td>
			<td style="width:16%;font-size:9px;">TIDAK KAWIN </td>
			<td style="width:3%"><img src="files/1721_box.png"></td>
			<td style="width:12%;font-size:9px;">LAKI-LAKI </td>
			<td style="width:3%;font-size:9px;"><img src="files/1721_box.png"></td>
			<td style="width:16%;font-size:9px;">PEREMPUAN </td>
			<td style="width:3%"><img src="files/1721_box.png"></td>
			<td style="width:28%;font-size:9px;">KARYAWAN ASING </td>
		</table>     
		</td>
	</tr>
	<tr>
		<td style="font-size:12px;width:42%;height:20px;">JUMLAH TANGGUNGAN KELUARGA UNTUK  PTKP</td>
		<td style="width:58%">
		<table style="width:100%;">
			<td style="width:5%">: K/</td>
			<td style="width:9px;border:1px;font-size:12px;text-align:center;">3</td>
			<td style="width:5%">&nbsp;</td>
			<td style="width:5%">TK/</td>
			<td style="width:9px;border:1px;font-size:12px;text-align:center;">3</td>
			<td style="width:5%">&nbsp;</td>
			<td style="width:5%">HB/</td>
			<td style="width:9px;border:1px;font-size:12px;text-align:center;">3</td>
		</table>
		</td>
	</tr>
	<tr>
		<td style="font-size:12px;width:42%;height:20px;">JABATAN</td>
		<td style="width:58%">
		<table style="width:100%;">
			<td style="width:1%">: </td>
			<td style="width:25%;border:1px solid;font-size:12px;"> </td>
			<td style=" font-size:12px;text-align:center;">MASA PEROLEHAN PENGHASILAN</td>
			
			<td style="width:9px;border:1px;font-size:12px;text-align:center;">3</td>
			<td style="width:9px;border:1px;font-size:12px;text-align:center;">3</td>
			<td style="width:15px;font-size:12px;text-align:center;">s.d</td>
			<td style="width:9px;border:1px;font-size:12px;text-align:center;">3</td>
			<td style="width:9px;border:1px;font-size:12px;text-align:center;">3</td>
			
		</table>
		</td>
	</tr>
</table>
</div> 
<div style="margin-top:2px;padding-bottom:3px;padding:0;border:1px solid;height:59%;width:99%">
<table style="width:100%;" cellspacing="0" cellpadding="2">
	<tr>
		<td colspan="3" style="font-size:12px;width:75%;height:20px;">A. RINCIAN PENGHASILAN DAN PENGHITUNGAN PPh PASAL 21 SEBAGAI BERIKUT</td>
		<td colspan="2" style="width:25%;background:#CDCDCD;border:1px solid;text-align:center" >RUPIAH </td>
	</tr>
	<tr>
		<td colspan="3" style="font-size:12px;width:75%;height:17px;">&nbsp; &nbsp;  <img width="5" src="files/1721_bullet.png"> &nbsp; PENGHASILAN BRUTO</td>
		<td colspan="2" style="width:25%;text-align:center" >&nbsp;</td>
	</tr>
	
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">1.</td>
		<td style="font-size:12px;width:70%;"> GAJI / PENSIUN ATAU THT / JHT</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >1 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 4.903.490 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">2.</td>
		<td style="font-size:12px;width:70%;"> TUNJANGAN PPh</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >2 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" >  0 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">3.</td>
		<td style="font-size:12px;width:70%;"> TUNJANGAN LAINNYA, UANG LEMBUR, DAN SEBAGAINYA</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >3 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 1.200.300 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">4.</td>
		<td style="font-size:12px;width:70%;"> HONORATIUM DAN IMBALAN JENIS LAINNYA</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >4 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 1.110.300 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">5.</td>
		<td style="font-size:12px;width:70%;"> PREMI ASURANSI YANG DIBAYAR PEMBERI KERJA</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >5 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 1.110.300 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:24px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">6.</td>
		<td style="font-size:12px;width:70%;line-height:13px;"> PENERIMAAN DALAM BENTUK NATURA DAN KENIKAMATAN LAINNYA YANG DIKENAKAN<br>
		PEMOTONGAN PPh PASAL 21</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >6 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" >  300 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">7.</td>
		<td style="font-size:12px;width:70%;"> JUMLAH ( 1 s.d 6 )</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >7 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" >  300 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">8.</td>
		<td style="font-size:12px;width:70%;">TANTIEM, BONUS, GRATIFIKASI, JASA PRODUKSI, DAN THR</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >8 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" >  300 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">9.</td>
		<td style="font-size:12px;width:70%;">JUMLAH PENGHASILAN BRUTO</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >9 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 9.300 </td>
	</tr>
	<tr>
		<td colspan="3" style="font-size:12px;width:75%;height:17px;">&nbsp; &nbsp; <img width="5" src="files/1721_bullet.png"> &nbsp; PENGHITUNGAN PPh PASAL 21</td>
		<td colspan="2" style="width:25%;text-align:center" >&nbsp;</td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">10.</td>
		<td style="font-size:12px;width:70%;">BIAYA JABATAN/BIAYA PENSIUN ATAS PENGHASILAN PADA ANGKA 7</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >10 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 700 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">11.</td>
		<td style="font-size:12px;width:70%;">BIAYA JABATAN/BIAYA PENSIUN ATAS PENGHASILAN PADA ANGKA 8</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >11 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 530 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">12.</td>
		<td style="font-size:12px;width:70%;">IURAN PENSIUN ATAU IURAN THT/JHT</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >12 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 1130 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">13.</td>
		<td style="font-size:12px;width:70%;">JUMLAH PENGURANGAN ( 10 + 11 + 12 )</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >13 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 9820 </td>
	</tr>
	<tr>
		<td colspan="3" style="font-size:12px;width:75%;height:17px;">&nbsp; &nbsp; <img width="5" src="files/1721_bullet.png"> &nbsp; PENGHITUNGAN PPh PASAL 21</td>
		<td colspan="2" style="width:25%;text-align:center" >&nbsp;</td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">14.</td>
		<td style="font-size:12px;width:70%;">JUMLAH PENGHASILAN NETO ( 9 - 13 )</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >14 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 9820 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">15.</td>
		<td style="font-size:12px;width:70%;">PENGHASILAN NETO MASA SEBELUMNYA</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >15 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 90820 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">16.</td>
		<td style="font-size:12px;width:70%;">JUMLAH PENGHASILAN NETO PENGHITUNGAN PPh PASAL 21 (SETAHUN/DISETAHUNKAN)</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >16 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 90820 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">17.</td>
		<td style="font-size:12px;width:70%;">PENGHASILAN TIDAK KENA PAJAK ( PTKP )</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >17 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 90820 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">18.</td>
		<td style="font-size:12px;width:70%;">PENGHASILAN  KENA PAJAK SETAHUN/DISETAHUNKAN</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >18 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 90820 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">19.</td>
		<td style="font-size:12px;width:70%;">PPh PASAL 21 ATAS PENGHASILAN KENA PAJAK SETAHUN/DISETAHUNKAN</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >19 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 90820 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">20.</td>
		<td style="font-size:12px;width:70%;">PPh PASAL 21 YANG TELAH DIPOTONG MASA SEBELUMNYA</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >20 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 987.820 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">21.</td>
		<td style="font-size:12px;width:70%;">PPh PASAL 21 TERUTANG</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >21 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 987.820 </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">22.</td>
		<td style="font-size:12px;width:70%;">PPh PASAL 21 TERUTANG</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >22 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 987.820 </td>
	</tr>
</table>
<table style="width:100%;" cellspacing="1" cellpadding="2">
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">&nbsp;</td>
		<td style="font-size:12px;width:50%;">22a. Dipotong dan dilunasi dengan SSP PPh Pasal 21 Ditanggung Pemerintah</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >22a </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 987.820 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;" >&nbsp; </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:20px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">&nbsp;</td>
		<td style="font-size:12px;width:50%;">22b. Dipotong dan dilunasi dengan SSP</td>
		<td style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >22b </td>
		<td style="vertical-align:middle;width:20%;text-align:center;border:1px solid;text-align:right;padding-right:10px;" > 9.820 </td>
		<td style="vertical-align:middle;width:20%;text-align:center;" >&nbsp; </td>
	</tr>
</table>
<table style="width:100%;" cellspacing="0" cellpadding="2">
	<tr>
		<td style="font-size:12px;width:2%;height:15px;">&nbsp;</td>
		<td  style="font-size:12px;width:3%;text-align:right;">23.</td>
		<td colspan="4" style="font-size:12px;width:95%;">JUMLAH PPh PASAL 21</td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:15px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">&nbsp;</td>
		<td style="font-size:12px;width:30%;border-bottom:1px solid"> <img src="files/1721_box_landscape.png"> a. YANG KURANG DIPOTONG (21-22)</td> 
		<td style="vertical-align:middle;width:40%;text-align:center;text-align:right;padding-right:10px;" >&nbsp;</td>
		<td rowspan="2" style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >23</td>
		<td rowspan="2" style="vertical-align:middle;width:20%;text-align:center;border:1px solid;" >&nbsp; </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:15px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">&nbsp;</td>
		<td style="font-size:12px;width:30%;"> <img src="files/1721_box_landscape.png"> b. YANG LEBIH DIPOTONG (21-22)</td> 
		<td style="vertical-align:middle;width:40%;text-align:center;text-align:right;padding-right:10px;" >&nbsp;</td>
	</tr>
</table>
<table style="width:100%;margin-bottom:2px;" cellspacing="0" cellpadding="2">
	<tr>
		<td style="font-size:12px;width:2%;height:15px;">&nbsp;</td>
		<td  style="font-size:12px;width:3%;text-align:right;">24.</td>
		<td colspan="6" style="font-size:12px;width:95%;">JUMLAH TERSEBUT PADA ANGKA 23 TELAH</td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:15px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">&nbsp;</td>
		<td style="font-size:12px;width:35%;border-bottom:1px solid"> <img src="files/1721_box_landscape.png"> a. DIPOTONG DARI PEMBAYARAN GAJI</td> 
		<td style="vertical-align:middle;width:25%;text-align:right;border-bottom:1px solid" >&nbsp; &nbsp; BULAN <img src="files/1721_box_1.png"><img src="files/1721_box_1.png"> TAHUN <img src="files/1721_box_1.png"><img src="files/1721_box_1.png"><img src="files/1721_box_1.png"><img src="files/1721_box_1.png"> </td>
		<td style="vertical-align:middle;width:10%;text-align:right;padding-right:10px;" >&nbsp;</td>
		<td rowspan="2" style="vertical-align:middle;width:5%;text-align:center;border:2px solid;text-align:center;" >24</td>
		<td rowspan="2" style="vertical-align:middle;width:20%;text-align:center;border:1px solid;" >&nbsp; </td>
	</tr>
	<tr>
		<td style="font-size:12px;width:2%;height:15px;">&nbsp;</td>
		<td style="font-size:12px;width:3%;text-align:right;">&nbsp;</td>
		<td style="font-size:12px;width:35%;"> <img src="files/1721_box_landscape.png"> b. DIPERHITUNGKAN DENGAN PPh PASAL 21</td> 
		<td style="vertical-align:middle;width:25%;text-align:right;" >&nbsp; &nbsp; BULAN <img src="files/1721_box_1.png"><img src="files/1721_box_1.png"> TAHUN <img src="files/1721_box_1.png"><img src="files/1721_box_1.png"><img src="files/1721_box_1.png"><img src="files/1721_box_1.png"> </td>
		<td style="vertical-align:middle;width:10%;text-align:right;padding-right:10px;" >&nbsp;</td>
	</tr>
</table>
</div> 

<div style="margin-top:2px;padding:0;padding-bottom:2px;border:1px solid;height:8%;width:99%">
<table style="width:100%;" cellspacing="0" cellpadding="2">
	<tr>
		<td colspan="2" style="font-size:12px;width:40%;height:20px;">B. TANDA TANGAN DAN CAP PERUSAHAAN</td>
		<td  style="width:32%;vertical-align:bottom;border-bottom:1px solid;text-align:center" >CILEGON </td>
		<td style="width:28%; text-align:center" ><img src="files/1721_box_1.png"><img src="files/1721_box_1.png"> &nbsp; <img src="files/1721_box_1.png"><img src="files/1721_box_1.png"> &nbsp; <img src="files/1721_box_1.png"><img src="files/1721_box_1.png"><img src="files/1721_box_1.png"><img src="files/1721_box_1.png"> </td>
	</tr> 
	<tr>
		<td  style="font-size:12px;width:3%;height:20px;">&nbsp;</td>
		<td  style="font-size:12px;width:37%;height:20px;"><img src="files/1721_box_landscape.png"> PEMOTONG PAJAK &nbsp; &nbsp; <img src="files/1721_box_landscape.png"> KUASA</td>
		<td style="width:32%;text-align:center;font-size:8px" >(tempat)</td>
		<td style="width:28%;text-align:center;font-size:8px" >   TGL &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; BLN &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; THN &nbsp; &nbsp;</td>
	</tr>
</table>

<table style="width:100%;" cellspacing="0" cellpadding="2">
	<tr>
		<td  style="font-size:12px;width:3%;height:20px;">&nbsp;</td>
		<td  style="font-size:12px;width:12%;height:20px;">NAMA LENGKAP</td>
		<td  style="font-size:12px;width:57%;height:20px;"><?php echo block_column(  "GUNTUR TEST" ,array() ,  24 );?> </td>
		<td style="width:28%;text-align:left;font-size:8px;text-align:center;" rowspan="2">
		<img src="files/1721_ttd.png">
		</td>
	</tr> 
	<tr>
		<td  style="font-size:12px;width:3%;height:20px;">&nbsp;</td>
		<td  style="font-size:12px;width:12%;height:20px;">NPWP  </td>
		<td  style="font-size:12px;width:57%;height:20px;"><?php echo block_column(  "07 761 " , array(3,7,11,13,17) ,  20 );?> </td>
	</tr>
</table>	
</div>
</div>  
<div style="width:100%;margin-left:-4px;padding:0;">
<table style="width: 100%;" align="center">
	<tr>
	<td style="width: 50%;text-align:left"><img src="files/1721_corner.png"></td>
	<td style="width: 50%;text-align:right"><img src="files/1721_corner.png"></td>
	</tr>
</table>	
</div><br><br> 
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